A confluence of topics dealing with mental health, substance abuse, health, public health, Social Work, education, politics, the humanities, and spirituality at the micro, mezzo, and macro levels. In short, this blog is devoted to the improvment of the quality of life of human beings in the universe.

"The true story of Dr. Miklos Nyiszli, a Hungarian Jew chosen by Josef Mengele to be the head pathologist at Auschwitz. Nyiszli was one of Auschwitz's Sonderkommandos - Special Squads of Jewish prisoners placed by the Nazis in the excruciating moral dilemma of helping to exterminate fellow Jews in exchange for a few more months of life. Together, the Sonderkommandos struggled to organize the only armed revolt that would ever take place at Auschwitz. As the rebellion is about to commence, a group from the unit discovers a 14-year-old girl who has miraculously survived a gassing. A catalyst for their desperate attempt at personal redemption, the men become obsessed with saving this one child, even if doing so endangers the uprising which could save thousands. To what terrible lengths are we willing to go to save our own lives, and what in turn would we sacrifice to save the lives of others?"

This movie is brutal in depicting the work of the Sonderkommandos, the Jewish prisoners forced to work in the crematoriums at Auschwitz in exchange for four more months of life and better food and drink. Altogether during the course of the gassing and buring of bodies there were 13 groups of Sonderkommandos who usually worked for 4 months before they were killed. The twelth group managed a rebellion which lead to the partial destruction of crematorium 3.

The story is factual based on the prison diaries of a Hungarian Jewish physician who was forced to perform human experiments himself in exchange for the special protection of his wife and daughter and his own life.

The inhumanity and cruelty seems not only outrageous, but numbingly unbelievable. Viewing this film is a sobering lesson in humility about how callous and "crazy" human ideologies can become especially when the ideology becomes a shared psychosis that people in power can perpetrate on their fellow human beings.

The bottom line is "Question ideological authority!"

I recommend this film but advise caution because of its content for children.

Because they rarely lead to the positive change that clients are looking for.

Attempting to affix blame, culpability, is usually not helpful even if the effort is accurate and successful in “telling it like it is or was”, so what?

It is much better to focus on preferences for the future.

I would much rather talk about how the client would like things to be. What would be better? How could things be different in ways that are more satisfying and fulfilling?

The only value in talking about the past with all its pain and suffering is to make sense out of it in such a way as to filter it for nuggets of wisdom that might serve us well in the future. Outside of that, talking about and processing the past has little value.

Given the bad stuff that has happened to you in the past, what have you learned from it, and how would you like things to be for you in the future?

As Tom Robbins said in one of his novels, “It’s never too late to have a happy childhood.”

I agree with Mr. Robbins completely.

Perhaps we should change our “whys” into “why nots”?

Why not be happy? Why not move forward to a high quality life full of satisfaction and fulfillment? You deserve it.

"The spectrum of alcohol withdrawal symptoms ranges from such minor symptoms as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens."

There is a good overview article in the March 15, 2004 issue of American Family Physician about the symptoms, diagnosis, and treatment of alcohol withdrawal syndrome. If you are at all interested or curious, it is a good overview of the topic.

"Illicit use of heroin, cocaine and other drugs helped fuel a dramatic rise in the number of accidental and unexplained poisoning deaths in the United States, health researchers said on Thursday.

The fatality rate from poisoning, excluding suicides and murders, rose an average 145 percent between 1990 and 2001, according to data collected by 11 states and published by the Centers for Disease Control and Prevention.

Narcotics and hallucinogens accounted for 51 percent of these deaths."

At GCASA where I work my day job we have seen 5 deaths since last November from substance abuse.

I am reminded every time someone dies that substance abuse can be a fatal disease.

The people who died were all young. They ranged in age from 21 to 43.

As substance abuse counselors we know that what precipitated these deaths were alcohol, cocaine, oxycontin, and heroin. What will show up on the death certificiates will be heart attack, metabolic complications, etc. In the article linked below which is based on a Morbidity and Mortality Weekly Report from the Center for Disease Control, they call them "poisonings" which is an accurate but unusual word. I don't know how often that people think of binge drinking, taking oxycontin for off label use, or snorting cocaine as "poisoning" but OK, I guess, it is. It certainly is "poisoning" when it inadvertently kills you.

At any rate, the report says that the number of "poisonings" have gone up in the last 10 years. This is something that is tragic because it is entirely preventable. Of course, it pales in terms of the number of Americans who die from "poisoning" their bodies with tobacco every year.

While the article says "There were 22,242 poisoning deaths in 2001 in the United States, 63 percent of which were unintentional. The overall death rate from poisonings - either intentional or unintentional - rose 56 percent between 1990 and 2001.", it is enlightening to know that 430,000 Americans die from tobacco each year. The largest group of smoking uptakers is 13 year old caucasion girls. They have no idea what they are doing to their bodies.

I wonder what the psychic pain is that leads people to poison themselves? What can we do to help people who find life so unbearable in their natural experience of it that they poison their systems to alter their mood? How can we help people to learn to live their lives without poisoning themselves?

I always have a book going, sometimes two or three. At any given time, I usually have a fiction book I read before I go to sleep, and a nonfiction book or two I am reading during the daytime.

We live in a time when there are enormous numbers of books to choose from. As the bumper sticker says, "So many books, so little time."

Having taken a trip to Barnes and Noble a couple of months ago, they have these neat little editions of classics available about the size of a paperback book except that the pages are gold edged and they have a ribbon in them and they were selling for $4.95.

Having read Great Expectations during high school, I have never read any other of Charles Dickens books and so I bought Tales Of Two Cities and Oliver Twist. I have loved both. He is one heck of a great writer. I just finished Oliver Twist and enjoyed it immensely.

"Oliver Twist's famous cry of the heart--"Please, sir, I want some more"--has resounded with generations of readers of all ages. The author poured his own youthful experience of Victorian London's unspeakable squalor into this realistic depiction of a spirited young innocent's unwilling but inevitable recruitment into a scabrous gang of thieves. Masterminded by the loathsome Fagin, the underworld crew features some of Dickens' most memorable characters, including the vicious Bill Sikes, gentle Nancy, and the juvenile pickpocket known as the Artful Dodger."

There are also memorable good people like Mr. Brownlow and Lady Maylie who rescue and believe in Oliver.

While the settings of Dickens' novels are usually in the early 1800s, the moral dilemnas his characters face are relevant and fresh today.

Oliver Twist is orphaned and brought up by self serving caretakers who go through the motions of appearing to care for children but wind up depriving them of the necessities of life, even food. The thieves of the day try to recruit Oliver into a life of crime after he runs away looking for a better life. In our modern day they might be crack dealers in any inner city or gang leader looking for 10 and 11 year old recruits who have parents, drug addicted themselves, who cannot care adequately for their children.

The book may be old fashioned in that the good guys triumph in the end while the bad guys pay the costs for their crimes. Life nowdays is not always that simple. Oliver Twist is a morality story and it is satisfying if not always realistic.

Psychiatric resident, Angela Harper, writes an interesting article for the Psychiatric News in the March 19, 2004 issue on how she came to appreciate psychotherapy.

"I saw myself as a future clinician who would be known for her strength in psychopharmacology, not as one who would be practicing psychotherapy. Time and experience sure have a way of changing people."

Nowdays, fewer psychiatrists practice psychotherapy. Most of them have become psychopharmacologists who prescribe medications. It is very heartening to read Dr. Harper's new found appreciation of psychotherapy for two reasons: first psychotherapy works, and secondly, when outcome studies are done and analyzed, it becomes apparent that for many psychiatric disorders psychotherapy gets much better outcomes as compared to medications.

Unfortunately, there rarely is a quick fix such as medications promise, and even in treating those disorders where medications are helpful such as schizophrenia and bipolar disorder, supportive psychotherapy adds a great deal to the quality of the life of the patient and their families, but also improves the effectiveness of the course of treatment as well.

For anyone who thinks that medications have made psychotherapy unnecessary or obsolete, they are seriously mistaken.